NPIMap

Individual provider Active NPI

Mark J Mancini, MD

  • Nephrology Physician
  • Westerly, RI
National Provider Identifier
1477579407
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD 10090 Issued in RI
Practice address
268 Post Rd Ste 204
Westerly, RI 02891-6601
Phone
(401) 596-3313
Fax
(401) 596-2650
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD 10090 RI Primary

Addresses

Primary practice location

268 Post Rd Ste 204
Westerly, RI 02891-6601

Mailing address

268 Post Rd Ste 204
Westerly, RI 02891-6601
Phone (401) 596-3313

Other practice location 1

70 Kenyon Ave Unit 326
Wakefield, RI 02879-4253
Phone (401) 782-0090

Other identifiers 1

IdentifierTypeStateIssuer
MD 10090OtherRISTATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100924000623 RI Practitioner - NephrologyPractitioner - Internal Medicine 4082627096 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD 10090RIMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Spring Health Care Management, Inc. CurrentSince Apr 1, 2014 Accepting new patients
Silver Spring Health Care Management, Inc. Nephrology CurrentSince Apr 1, 2014 Accepting new patients
Silver Spring Health Care Management, Inc. Nephrology Past Accepting new patients
Silver Spring Health Care Management, Inc Past Accepting new patients

Locations

3461 S County Trl
Ste 301
East Greenwich, RI 02818
Phone (401) 471-6285

70 Kenyon Ave
Unit 211
Wakefield, RI 02879
Phone (401) 789-8543

70 Kenyon Ave
#104
Wakefield, RI 02879
Phone (401) 782-0900

70 Kenyon Ave
Unit 326
Wakefield, RI 02879
Phone (401) 782-0090

70 Kenyon Ave
Ste 270
Wakefield, RI 02879
Phone (401) 782-0090

268 Post Rd
Westerly, RI 02891
Phone (401) 562-1017

268 Post Rd
Ste 204
Westerly, RI 02891
Phone (401) 788-2110

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 16

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of Connecticut School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Silver Spring Health Care Management Inc 136 clinicians

Practice addresses (Care Compare)

100 Kenyon Ave
Wakefield, RI 02879-4216
Phone (401) 782-8000

268 Post Rd
Suite 204
Westerly, RI 02891-6601
Phone (401) 596-3313

70 Kenyon Ave
Suite 270
Wakefield, RI 02879-4239
Phone (401) 782-0090

70 Kenyon Ave
Unit 211
Wakefield, RI 02879-4241
Phone (401) 789-8543

Hospital & facility affiliations

  • Dialysis Center of Westerly Dialysis facility, Westerly, RI, CCN 412502
  • Wakefield Dialysis Center Dialysis facility, Wakefield, RI, CCN 412507
  • South County Hospital Inc Hospital, Wakefield, RI, CCN 410008
  • Westerly Hospital Hospital, Westerly, RI, CCN 410013
  • Lawrence & Memorial Hospital Hospital, New London, CT, CCN 070007
  • The Miriam Hospital Hospital, Providence, RI, CCN 410012

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1477579407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 POST RD STE 204",
            "city": "WESTERLY",
            "state": "RI",
            "postal_code": "028916601",
            "telephone_number": "401-596-3313",
            "fax_number": "401-596-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 POST RD STE 204",
            "city": "WESTERLY",
            "state": "RI",
            "postal_code": "028916601",
            "telephone_number": "401-596-3313",
            "fax_number": "401-596-2650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 Kenyon Ave Unit 326",
            "address_purpose": "LOCATION",
            "city": "Wakefield",
            "state": "RI",
            "postal_code": "028794253",
            "country_code": "US",
            "telephone_number": "401-782-0090",
            "fax_number": "401-782-0888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANCINI",
        "first_name": "MARK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "RI",
            "license": "MD 10090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "MD 10090",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerly, RI

Sources for this page

Verify at the official NPI Registry.